| Doctor Name: | EDDIE J SIMMONS |
| NPI Number: | 1104973742 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 58588 |
| Business Practice Address: | 2480 Llewellyn Ave Fort George G Meade, MD - 207555800 |
| Business Phone Number: | 3016778270 |
| Business Fax Number: | 3016778176 |
| Mailing Address: | 2480 Llewellyn Ave, FORT GEORGE G MEADE |
| State: | MD |
| Postal Code: | 207555800 |
| Phone Number: | 3016778270 |
| Fax Number: | 3016778176 |
| NPI Enumeration Date: | 01/05/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WA2000X |
| License Number: | 58588 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Administrator |
| Taxonomy Definition: | |